OBJECTIVETo study the effects of Weipixiao (胃痞消, WPX) on Wnt pathway-associated proteins in gastric mucosal epithelial cells from rats with gastric precancerous lesions (GPL).

METHODSSprague Dawley rats were randomly divided into control, model, vitacoenzyme (0.2 g·kg(-1)·day(-1)), WPX high-dose (H-WPX, 15 g·kg(-1)·day(-1)), WPX medium-dose (M-WPX, 7.5 g·kg(-1)·day(-1)) and WPX low-dose (L-WPX, 3.75 g·kg(-1)·day(-1)) groups. After successfully establishing the GPL model, the rats were consecutively administered WPX or vitacoenzyme by gastrogavage for 10 weeks. Differential expression of Leucine-rich repeat-containing G-proteincoupled receptor 5 (Lgr5), matrix metalloproteinase-7 (MMP-7), Wnt1, Wnt3a, and β-catenin in gastric mucosal epithelial cells in all groups were immunohistochemically detected, and the images were taken and analyzed semiquantitatively by image pro plus 6.0 software.

RESULTSGastric epithelium in the model group showed significantly higher expression levels of Lgr5, MMP-7, Wnt1, Wnt3a and β-catenin than those of the control group(P<0.01). Interestingly, we also observed Lgr5+ cells, which generally located at the base of the gastric glandular unit, migrated to the luminal side of gastric epithelium with GPL. The expression levels of Lgr5, MMP-7, Wnt1, and β-catenin were all down-regulated in the L-WPX group as compared with those of both model and vitacoenzyme groups (P<0.05). A similar, but nonsignificant down-regulation in expression level of Wnt3a was noted in all WPX groups (P>0.05).

CONCLUSIONOur findings suggested that the therapeutic mechanisms of WPX in treating GPL might be related with its inhibitory effects on the expressions of Lgr5, MMP-7, Wnt1, β-catenin and the aberrant activation of Wnt/β-catenin pathway.

Animals ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Epithelial Cells ; drug effects ; metabolism ; pathology ; Gastric Mucosa ; pathology ; Immunohistochemistry ; Male ; Matrix Metalloproteinase 7 ; metabolism ; Precancerous Conditions ; drug therapy ; pathology ; Rats, Sprague-Dawley ; Receptors, G-Protein-Coupled ; metabolism ; Staining and Labeling ; Stomach Neoplasms ; drug therapy ; pathology ; Wnt Proteins ; metabolism ; Wnt Signaling Pathway ; drug effects ; beta Catenin ; metabolism

Gastric dysplasia is a neoplastic lesion and a precursor of gastric cancer. The Padova, Vienna, and World Health Organization classifications were developed to overcome the discrepancies between Western and Japanese pathologic diagnoses and to provide a universally accepted classification of gastric epithelial neoplasia. At present, the natural history of gastric dysplasia is unclear. Much evidence suggests that patients with high-grade dysplasia are at high risk of progression to carcinoma or synchronous carcinoma. Therefore, endoscopic resection is required. Although patients with low-grade dysplasia have been reported to be at low risk of progression to carcinoma, due to the marked histologic discrepancies between forceps biopsy and endoscopic specimens, endoscopic resection for this lesion is recommended, particularly in the presence of other risk factors (large size; depressed gross type; surface erythema, unevenness, ulcer, or erosion; and tubulovillous or villous histology). Helicobacter pylori eradication in patients with dysplasia after endoscopic resection appear to reduce the incidence of metachronous lesions.
Anti-Bacterial Agents/therapeutic use ; Biopsy ; Carcinoma in Situ/classification/microbiology/*pathology/*surgery ; Disease Progression ; *Gastrectomy/adverse effects/methods ; Gastric Mucosa/microbiology/*pathology/*surgery ; Gastroscopy ; Helicobacter Infections/drug therapy/microbiology ; Helicobacter pylori/drug effects ; Humans ; Neoplasm Grading ; Precancerous Conditions/classification/microbiology/*pathology/*surgery ; Predictive Value of Tests ; Risk Factors ; Stomach Neoplasms/classification/microbiology/*pathology/*surgery ; Treatment Outcome

Endometrial Neoplasms ; drug therapy ; pathology ; Female ; Humans ; Precancerous Conditions ; drug therapy ; pathology ; Progestins ; therapeutic use

Borderline ovarian tumors (BOTs) represent about 15% to 20% of all ovarian malignancies and differ from invasive ovarian cancers (IOCs) by many characters. Historically, standard management of BOT is peritoneal washing cytology, hysterectomy, bilateral salpingo-oophorectomy, omentectomy, complete peritoneal resection of macroscopic lesions; in case of mucinous BOTs, appendectomy should be performed. Because BOTs are often diagnosed at earlier stage, in younger age women and have better prognosis, higher survival rate than IOCs, fertility-sparing surgery is one of the option to preserve childbearing capacity. The study of such conservative surgery is being released, and still controversial. After surgery, pregnancy and ovarian induction followed by in vitro fertilization are also significant issues. In surgery, laparoscopic technique can be used by a gynecologic oncology surgeon. So far postoperative chemotherapy, radiotherapy and hormone therapy are not recommended. We will discuss controversial issues of BOTs on this review and present the outline of the management of BOTs.
Biopsy ; Chemotherapy, Adjuvant ; Female ; Humans ; Infertility, Female/prevention & control ; Intraoperative Care/methods ; Laparoscopy/methods ; Laparotomy/methods ; Neoplasm Recurrence, Local/therapy ; Neoplasm Staging ; Organ Sparing Treatments/methods ; Ovarian Neoplasms/pathology/*therapy ; Ovary/*pathology ; Precancerous Conditions/pathology/therapy

With improved overall survival of cervical cancer patients, the importance of the quality of life (QOL) is increasingly recognized. This study was conducted to compare the QOL of women with different stage cervical cancer before and after treatment to facilitate improved cervical cancer prevention and treatment. We used the generic Medical Outcomes Study Short Form-36 (MOS SF-36) to collect QOL information. Based on SF-36, we interviewed cervical cancer patients at West China Second Affiliated Hospital and Sichuan Cancer Hospital between May 2010 and January 2011. A total of 92 patients with precancerous lesions, 93 with early cancer, and 35 with advanced cancer responded to our survey. Average physical component summary (PCS) scores were significantly different between the three groups at every time point (P < 0.05). Average mental component summary (MCS) scores were significantly different between the three groups after treatment (P < 0.05). Average PCS and MCS scores increased gradually from the pretreatment to posttreatment period for patients with precancerous lesions. However, they reached the lowest at 1 month after treatment for patients with early and advanced cancers and rebounded between 1 and 6 months after treatment. Our results indicate that patients with precancerous lesions and early cervical cancer show better overall QOL than do those with advanced cervical cancer. Additionally, patients with early cancer recover more quickly than do those with advanced cancer in terms of both physical and mental functions. Thus, early detection and treatment initiatives may improve the QOL for patients with precancerous lesions and cervical cancer.
Adult ; Aged ; Carcinoma in Situ ; pathology ; therapy ; Cervical Intraepithelial Neoplasia ; pathology ; therapy ; Chemoradiotherapy ; China ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; methods ; Lymph Node Excision ; Middle Aged ; Neoplasm Staging ; Precancerous Conditions ; pathology ; therapy ; Quality of Life ; Surveys and Questionnaires ; Uterine Cervical Neoplasms ; pathology ; therapy ; Young Adult

BACKGROUND/AIMS: Eradication of Helicobacter pylori reduces the incidence of gastric cancer, and may inhibit gastric dysplasia progression into gastric cancer. The aim of this study was to investigate the effect of eradication of Helicobacter on the incidence of subsequent gastric dysplasia development after endoscopic resection. METHODS: Medical records of patients who underwent endoscopic resection for gastric dysplasia were retrospectively reviewed. Presence of H. pylori was assessed by the Campylobacter-like organism test and histology. The rate of subsequent dysplasia development after endoscopic resection between the eradication group and non-eradication group was compared. RESULTS: Total of 129 patients positive for H. pylori infection were included for analysis. Of these, 85 patients received successful eradication therapy and 44 patients did not receive eradication therapy or failed to achieve successful eradication. Sex, mean age and pathologic grade of dysplasia did not differ between the two groups. In univariate analysis, the grade of intestinal metaplasia (p=0.013) significantly differed between metachronous dysplasia group and non-metachrounous dysplasia group. In multivariate analysis, eradication of H. pylori (p=0.014) was related to reduced incidence of subsequent gastric dysplasia development after endoscopic resection. CONCLUSIONS: Eradication of H. pylori likely has a beneficial effect in preventing the development of subsequent gastric dysplasia, a premalignant lesion of gastric cancer, after endoscopic resection.
Aged ; Anti-Bacterial Agents/*therapeutic use ; Female ; Gastric Mucosa/pathology/surgery ; Gastroscopy ; Helicobacter Infections/*drug therapy ; *Helicobacter pylori ; Humans ; Male ; Metaplasia/pathology ; Middle Aged ; Neoplasm Recurrence, Local/pathology ; Precancerous Conditions/*pathology ; Proportional Hazards Models ; Retrospective Studies ; Stomach Neoplasms/pathology/*surgery

Drugs, Chinese Herbal ; therapeutic use ; Humans ; Phytotherapy ; Precancerous Conditions ; drug therapy ; pathology ; Stomach Neoplasms ; drug therapy ; pathology

OBJECTIVETo study the therapeutic effect of Weiyan serial recipes (WYSR) in treatment of chronic atrophic gastritis (CAG) accompanied with intestinal metaplasia (IM) and/or dysplasia (Dys) and to explore its molecular mechanisms for reversing the gastric precancerous lesions.

METHODSOne hundred and fifty patients with confirmed diagnosis of CAG accompanied with IM and/or mild Dys were randomly assigned to the treatment group (120 cases) and the control group (30 cases). Patients in the treatment group were respectively treated with WYSR I-IV according to Chinese medicine syndrome typing as incoordination of Gan and Wei syndrome (32 cases), deficiency of Pi and Wei syndrome (35 cases), insufficient Wei-yin syndrome (28 cases), and stasis stagnation in Wei-channel syndrome (25 cases). Patients in the control group orally took Weifuchun Pill. The therapeutic course for all was 3 months, and totally 2 courses. The clinical effects, changes under the gastroscope, the pathological changes, and expressions of gastric mucosal hypoxia-inducible factor-1alpha(HIF-1alpha), vascular endothelial growth factor (VEGF) protein were compared between the two groups before and after treatment.

RESULTSThe total effective rate of the treatment group was 86.7% and the total effective rate of the gastroscopic changes was 78.3%, which was higher than those of the control group (56.7% and 40.0%), showing significant difference (P < 0.01, P < 0.05). The total effective rate of clinical symptoms and that of the pathological changes were higher in the treatment group than in the control group with statistical significance shown (P < 0.05). There was no statistical difference in the expressions of HIF-1alpha and VEGF protein of the control group between before and after treatment (P > 0.05). Compared with before treatment, the post-treatment expressions of HIF-1alpha and VEGF protein both obviously decreased in the treatment group (P < 0.01), and were lower than those in the control group (P < 0.05).

CONCLUSIONSWYSR showed better effects on treating gastric precancerous lesions. It could significantly improve the atrophy, IM, and Dys, and promote the reversal of gastric precancerous lesions. Its mechanisms might possibly be correlated with inhibiting the over-expressions of HIF-1alpha and VEGF protein.

Adult ; Aged ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Gastritis, Atrophic ; drug therapy ; metabolism ; pathology ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Male ; Middle Aged ; Phytotherapy ; Precancerous Conditions ; drug therapy ; metabolism ; pathology ; Stomach Neoplasms ; prevention & control ; Vascular Endothelial Growth Factor A ; metabolism ; Young Adult

OBJECTIVETo study the clinicopathologic features, immunophenotypes and differential diagnoses of invasive carcinoma arising in breast microglandular adenosis (MGACA).

METHODSClinical and pathologic findings of 3 cases of MGACA were analyzed by histomorphology and immunohistochemical staining of CK7, S-100 protein, ER, PR, HER2, SMA, MSA, p63 and PAS. Literatures were reviewed.

RESULTS(1) Histologically, 3 tumors all showed a spectrum of glandular proliferations ranging from microglandular adenosis (MGA) to atypical microglandular adenosis (AMGA) to in situ carcinoma (DCIS) to invasive carcinoma. The invasive carcinoma component was ductal in case 1, and matrix-producing in case 2 and case 3. (2) All epithelial cells in MGA, AMGA, DCIS and MGACA were positive for CK7 and S-100 protein, but were negative for ER and HER2. PR was negative in case 1 and case 2 but was low positive in case 3. Myoepithelial cell differentiation was not demonstrated in MGA, AMGA, DCIS and MGACA by immunohistochemical staining for SMA, MSA or p63. PAS staining showed the presence of basement membrane in MGA, AMGA and DCIS, except MGACA.

CONCLUSIONSMGACA is an extremely rare tumor of the breast and has distinct morphological and immunohistochemical features. Further studies are needed to evaluate the clinical behavior of this rare neoplasm.

Adult ; Breast Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; Carcinoma, Ductal, Breast ; drug therapy ; metabolism ; pathology ; surgery ; Carcinoma, Intraductal, Noninfiltrating ; drug therapy ; metabolism ; pathology ; surgery ; Cell Transformation, Neoplastic ; Diagnosis, Differential ; Disease Progression ; Female ; Fibrocystic Breast Disease ; drug therapy ; metabolism ; pathology ; surgery ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Keratin-7 ; metabolism ; Mastectomy, Modified Radical ; Middle Aged ; Precancerous Conditions ; drug therapy ; metabolism ; pathology ; surgery ; Receptors, Progesterone ; metabolism ; S100 Proteins ; metabolism

Antibodies, Monoclonal ; therapeutic use ; Antibodies, Monoclonal, Humanized ; Antineoplastic Agents ; therapeutic use ; Cadherins ; genetics ; metabolism ; Carcinoma, Papillary ; pathology ; Cetuximab ; Colorectal Neoplasms ; drug therapy ; genetics ; pathology ; Consensus ; Dissent and Disputes ; Drug Delivery Systems ; Epithelial-Mesenchymal Transition ; Gastrointestinal Neoplasms ; classification ; pathology ; Genes, ras ; Humans ; Mutation ; Neoplasm Invasiveness ; Neoplastic Syndromes, Hereditary ; genetics ; metabolism ; pathology ; Neuroendocrine Tumors ; classification ; pathology ; Precancerous Conditions ; pathology ; Stomach Neoplasms ; genetics ; metabolism ; pathology